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腹会阴切除术后的盆腔重建:使用可吸收合成假体的初步研究。

Pelvic reconstruction after abdominoperineal resection: a pilot study using an absorbable synthetic prosthesis.

机构信息

Department of Surgery, La Mancha Centro General Hospital, Avenida de la Constitución, s/n, 13600 Alcazar de San Juan, Ciudad Real, Spain.

出版信息

Tech Coloproctol. 2011 Dec;15(4):455-9. doi: 10.1007/s10151-011-0763-8. Epub 2011 Sep 29.

Abstract

BACKGROUND

Abdominoperineal resection (APR) is not free of complications, in particular complications due to the occupation of the pelvis by the small bowel after surgery. A number of surgical techniques have been described to prevent the small bowel from entering and adhering to the pelvis (pelvic partition), but there is no agreement concerning their use. The aim of this study was to evaluate the feasibility, effectiveness and safety of using an absorbable synthetic prosthetic material for pelvic partitioning after APR.

METHODS

A prospective non-randomised longitudinal pilot study was carried out on a series of 10 patients who underwent APR due to lower-third rectal cancer, in order to evaluate the feasibility, safety and efficacy of pelvic partitioning with an absorbable synthetic prosthetic material.

RESULTS

In all the patients, it was possible to perform a radical resection and to install the prosthesis. After a mean follow-up of 9 months (range: 4-18 months), no abdominal or perineal complications were detected. One patient (10%) suffered chronic pelvic pain.

CONCLUSIONS

Pelvic partition after APR of the rectum with an absorbable synthetic prosthesis is feasible, effective and safe.

摘要

背景

腹会阴联合切除术(APR)并非没有并发症,特别是由于手术后小肠占据骨盆而引起的并发症。已经描述了许多手术技术来防止小肠进入和附着在骨盆(骨盆分隔)上,但关于它们的使用尚未达成共识。本研究旨在评估 APR 后使用可吸收合成假体材料进行骨盆分隔的可行性、有效性和安全性。

方法

对 10 例因低位直肠癌而行 APR 的患者进行了前瞻性非随机纵向试点研究,以评估使用可吸收合成假体材料进行骨盆分隔的可行性、安全性和疗效。

结果

所有患者均能进行根治性切除并安装假体。平均随访 9 个月(范围:4-18 个月)后,未发现腹部或会阴部并发症。1 例(10%)患者患有慢性盆腔痛。

结论

使用可吸收合成假体进行 APR 后的直肠骨盆分隔是可行、有效且安全的。

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